Interpretation Questions - My OSCAR Data

[ApneaQuestions]

I posted some stuff on flow waves here
http://www.apneaboard.com/forums/Thread-...#pid320050

 Hey that's awesome... Thanks again for another great lead from OZ !
 Some of those perfect rounded shapes may be setting me a potentially unachievable goal with my internal plumbing... we'll see...

[ApneaQuestions]

Here's my final attempt at tweaking the Resmed 10 Autoset

I've taken the minimum pressure as far as I want to go (10 cmw ) to snug right up to my median pressure with max "Pressure Support" (EPR 3 cmw)

My pressures are now hardly changing so I've basically turned the APAP into a basic CPAP (or a basic BIPAP if you add in the EPR=3 effect)

I'm starting to get "facial flatulence" (FF) from my mask and higher pressures would just make that worse. 
The FF is probably causing more arousals than the flow limits.


From here on I will be using the Resmed 10 VAuto.   I will start with the prescribed defaults and tweak it from there.  Initial PS=4

Attached zooms show..
1) flow-limited "CA" followed immediately by a mini-apnea  (The CA flag seems debatable to me)
2) flow-limited Hypopnea

Story so far..

[ApneaQuestions]

Story so far

[Plmnb]

...I found this, thought it was pretty nifty:...

Yes that is nifty!  Thanks for sharing it.  It fits in very nicely with my interest in waveforms.
I'll go hunt down your thread and take a peek at some of your graphs to see if you are doing the same type of zooms that I'm doing once you start on the BIPAP.
It's an interesting subject isn't it?

 Definitely interesting, although quite confusing.  I was just thinking this morning...what type of weirdo am I that I can't wait to get to my computer and insert the SD card to see how I slept during the night?  I have other things in my life to occupy me, but posting and reading in this forum has become quite important to me.

Plmnb

[Plmnb]

I am curious, what would a GOOD or NORMAL, as normal as possible anyway...FLOW RATE graph look like?

I'm not talking directly to Plmnb here... I'm just quoting your question.

One word of warning here... if you can look at  these waveforms and have a calm dispassionate approach then that's great and may be interesting and fun.

However, there may be a tendency for some personalities to over-analyze and start freaking out every time they see something that's not exactly sinusoidal and smooth.

I'm in the former group.. if anyone reading this suspects you might be in the latter group.... chill out and watch a movie instead.

Not every chest pain is a heart attack. Not every waveform needs to be "fixed".  But you knew that... right?

 At the moment I guess I am in the later group.

[ApneaQuestions]

I am curious, what would a GOOD or NORMAL, as normal as possible anyway...FLOW RATE graph look like?

I'm in the former group.. if anyone reading this suspects you might be in the latter group.... chill out and watch a movie instead.

 At the moment I guess I am in the later group.

Not really... your flow limitations really DO need to be sorted and that's why you are getting the new BIPAP.  :-)

[Plmnb]

I'm in the former group.. if anyone reading this suspects you might be in the latter group.... chill out and watch a movie instead.

 At the moment I guess I am in the later group.

Not really... your flow limitations really DO need to be sorted and that's why you are getting the new BIPAP.  :-)

Awwe, thank you ApneaQuestions!  You made me feel less crazy today. 

[ApneaQuestions]

Just noticed something..

Did anyone spot the "Norwegian YES" gasp?

Actually it's not quite the same because I performed a rapid startled in-then-out .. but similar

Here's the Norwegian YES video again...
https://www.youtube.com/watch?v=nutMYpTqLe4

I mentioned it recently on this thread...
http://www.apneaboard.com/forums/Thread-...#pid323332

[ApneaQuestions]

Here's a plot I just posted on this other thread
http://www.apneaboard.com/forums/Thread-...#pid325177

It brings the RERA and waveforms into perspective using a more clinically-significant case

[ApneaQuestions]

Just bringing all my info "home" to my thread.  I recently posted this on another thread...

I use Kaiser Permanente.

They are a non-profit organization that does not use an explicit insurance company so there is no need for the doctors to try to convince insurers to pay up.

In my experience so far, if the Doctor feels that something is justified and necessary... it happens.
Their focus seems to be on getting the best clinical outcomes instead of maximizing profits... after all... they don't have profits.

They are as close to a single-payer single-provider system that I could find in the US.

I have had incredible cooperation with each and every doctor and specialist that I have seen.
The Kaiser approach is to encourage patients to be well-informed working with their doctors as a collaborative team.

I can email my doctors and specialists at any time and I usually get a response the same day.
I can self-refer to any specialist without needing referrals from a General Practitioner. That includes physiotherapy and probably includes psychotherapy too.

Most of my prescription requests were done without needing to see the doctor face-to-face. 
They have online chat services, email services, video-link services and (if you prefer) you can see them face to face.. but you are not forced to. 
They are not interested in billing for office visits because there is no insurance company to bill.  If the patient is happy with rapid email turnaround.. they are too.
The doctors are employees and they earn their salary without needing to find ways to do extra billing.  The facilities are sparkling and new.

I sent my Doctor an email attaching OSCAR data and a narrative telling her what to look for and a logical reasoned argument why I felt a different machine would be beneficial.
She sent that email to a colleague to validate the argument and then immediately approved the prescription with an option for me to purchase or rent at my own discretion.
I also asked for a paper lifetime prescription in case I ever switch providers and she did that immediately too without hesitation.

Anything that I feel I need (with a convincing argument explaining why) I get. It's that simple.
Isn't that the way it's supposed to be?
Oh.. BTW.. The DME is Apria. The prescriptions are always "fill as written" so no games downgrading to brick machines either. The machines are all from the top recommended list on the forum. Kaiser have a stock of loaner machines too which they will lend you for a week or so to see if the machine is suitable for you.. at no charge.